DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20162851

Cost variation analysis of antidyslipidemic drugs

Ajay Kumar Shukla, Parag Sharma

Abstract


Background: Dyslipidemia is the most common cause of premature coronary atherosclerosis manifesting as ischemic heart disease. Hyperlipidemia has a major role in the causation of atherosclerosis and atherosclerosis-induced conditions, such as ischemic cerebrovascular disease, coronary heart disease (CHD) and peripheral vascular disease.

Methods: The prices of 07 antidyslipidemic drugs, available in 19 different formulations marketed in 260 brands and 03 fixed dose combinations available in 11 different formulations marketed in 75 brands were analyzed. Costs of different brands of a particular generic antidyslipidemic drug being manufactured by different companies, in the same strength and dosage forms were used to calculate cost ratio and percentage cost variation.

Results: In this study, it was found that there exists a wide cost variation among the different brands of same antidyslipidemic drugs in Indian market. Among individual antidyslipidemic drugs, highest cost ratio and percent cost variation was found for atorvastatin 20 mg, followed by atorvastatin 10 mg and atorvastatin 5 mg. Among fixed dose combinations for antidyslipidemic drugs, highest cost ratio and percent cost variation was found for atorvastatin 20 mg+fenofibrate 160 mg, followed by atorvastatin 10 mg+ezetimibe 10 mg and atorvastatin 20 mg+ezetimibe 10 mg. Highest number of brands of antidyslipidemic drugs available in Indian market are for atorvastatin 10 mg followed by atorvastatin 20 mg and rosuvastatin 10 mg. Highest number of brands of fixed dose combinations of antidyslipidemic drugs available in Indian market are for atorvastatin 10 mg+ezetimibe 10 mg and atorvastatin 10 mg+fenofibrate 160 mg.

Conclusions: In Indian market, there is very wide price variation of different brands of the same generic antidyslipidemic drug. Treatment of dyslipidemia has long course of treatment. For long term adherence to the treatment, cost of a drug plays an important role for successful drug treatment. Various steps are needed to reduce this wide price variation of different brands of the same generic antidyslipidemic drug.


Keywords


Cost analysis, Compliance, Adherence, Dyslipidemia, Health economics, Cost variation

Full Text:

PDF

References


Talbert RL. Dyslipidemia. Dipiro JT, Lamber RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: a Pathophysiologic Approach. 19th edition. New York, NY: McGraw-Hill; 2011:365-84.

Menotti A, Lanti M, Nedeljkovic S, Nissinen A, Kafatos A, Kromhout D. The relationship of age, blood pressure, serum cholesterol and smoking habits with the risk of typical and atypical coronary heart disease death in the European cohorts of the seven countries study. Int J Cardiology. 2006;106:157-63.

Bersot TP. Drug therapy for hypercholesterolemia and dyslipidemia. In: Brunton LB, Chabner BA, Knollman BC, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics.12th ed. New York, NY:Mcgraw-Hill;2011:877-904.

Tripathi KD. Essentials of Medical Pharmacology.7th edition. New Delhi: Jaypee Brothers Medical Publishers Pvt. Limited; 2013.

Krisko TI, Armstrong EJ, Cohen DE. Pharmacology of cholesterol and lipoprotein metabolism. In: Golan DE, Tashjian Jr. AH, Armstrong EJ, Armstrong AW eds. Principles of pharmacology: the pathophysiologic basis of drug therapy. 4th ed.Philadelphia : Wolters Kluwer Health/Lippincott Williams and Wilkins, 2017:336-55.

India in business. Ministry of External affairs, Govt. of India. Investment and Technology Promotion Division. Available at http: //indiainbusiness.nic.in /newdesign/index.php?param=industryservices_landing/347/1. Accessed on 31July 2016.

Das SC, Mandal M, Mandal SC. A critical study on availability and price variation between different brands: Impact on access to medicines. Indian J Pharm Sci. 2007;69(1):160‑3.

Pharmacoeconomics: Principles, Methods, and Applications. Dipiro JT, Lamber RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: a Pathophysiologic Approach. 19e. New York, NY: McGraw-Hill;2011:01.

Operational Guidelines on Free drug service Initiative. National Health Mission. Available from: https://mpphscl.in/Files/PDF/b731acad-eded-43b6-b2869aea308b1fb_0_Free_Drugs_Service_Intitiative.pdf. Accessed on 31 July 2016.

Gupta SK. Proposed Pharmacoeconomics Guidelines for India (PEG-I). IPSOR India. 2013;79:100.

Shrank WH, Hoang T, Ettner SL. The implications of choice: prescribing generic or preferred pharmaceuticals improves medication adherence for chronic conditions. Arch Intern Med. 2006;166(3):332-7.

Akila L, Rani RJ. Cost analysis of different brands of antianginal drugs available in India. Int J Basic Clin Pharmacol. 2015;4:860-3.

National list of essential medicines 2015. Available from: http://www.drugscontrol.org/pdf/NLEM-2015.pdf. Accessed on 22 July 2016.

National List of Essential Medicines, 2011. Available at: http: //www.who.int /selection_medicines/country_lists /India_ NLEM _2011. pdf. Accessed on 31 July 2016.

Creese A, Kotwani A, Kutzin J, Pillay A. Evauating pharmaceuticals for health policy in low and middle income country settings. In: Freemantle N, Hill S, editors. Evaluating pharmaceuticals for health policy and reimbursement. Massachusetts, USA: Blackwell Publication; (in collaboration with WHO Geneva); 2004:227-43.

Ho PM, Bryson CL, Rumsfeld JS. Medication Adherence: Its Importance in Cardiovascular Outcomes. Circulation. 2009;119:3028-35.

Singal GL, Nanda A, Kotwani A. A comparative evaluation of price and quality of some branded versus branded-generic medicines of the same manufacturer in India. Indian J Pharmacol. 2011;43:131-6.

Allan GM, Lexchin J, Wiebe N. Physician awareness of drug cost: a systematic review. PLoS Med. 2007;4(9):283.

Frazier LM, Brown JT, Divine GW, Fleming GR, Philips NM, Siegal WC, et al. Can physician education lower the cost of prescription drugs? A prospective, controlled trial. Ann Intern Med. 1991;115(2):116-21.

Shukla AK, Mehani R. Cost analysis of antiepileptic drugs available in India. Int J Basic Clin Pharmacol. 2016;5:1636-40.

Shukla AK, Sharma P. Cost variation study of antidepressant drugs. Int J Basic Clin Pharmacol. doi:10.18203/2319-2003.ijbcp20162695.